Provider Demographics
NPI:1427728666
Name:TUZOLANA, BELINDA S (NP)
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:S
Last Name:TUZOLANA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9129 STONE MILL LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-8119
Mailing Address - Country:US
Mailing Address - Phone:682-433-8308
Mailing Address - Fax:
Practice Address - Street 1:4100 HERITAGE AVE
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-5714
Practice Address - Country:US
Practice Address - Phone:682-999-8446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-19
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX839778163W00000X
TXAG09210045363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse